皖南医学院学报
皖南醫學院學報
환남의학원학보
ACTA ACADEMIAE MEDICINAE WANNAN
2014年
5期
396-398,399
,共4页
毛桐俊%许国飞%李志%陆进明
毛桐俊%許國飛%李誌%陸進明
모동준%허국비%리지%륙진명
成人斯蒂尔病%临床特点%治疗%转归
成人斯蒂爾病%臨床特點%治療%轉歸
성인사체이병%림상특점%치료%전귀
adult onset Still′s disease%clinical feature%therapy%prognosis
目的：探讨成人斯蒂尔病（ AOSD）的临床特点、实验室检查结果、疗效及转归。方法：回顾性分析82例AOSD患者的临床资料，总结临床特征、药物治疗方法、疗效并进行随访。结果：临床表现为高热98．78％，皮疹95．12％，关节痛和（或）关节炎82．93％，咽痛78．05％，淋巴结肿大41．06％，脾脏肿大36．59％；实验室检查中白细胞增多78．05％，C 反应蛋白升高98．78％，红细胞沉降率增快97．56％，血清铁蛋白升高97．56％，乳酸脱氢酶升高86．21％，纤维蛋白原升高76．79％，D-二聚体升高80．36％，肝功能异常40．24％。98．78％应用糖皮质激素，89．02％患者联合应用了免疫抑制剂；血清铁蛋白≥2000 ng／ml组复发率高达71．43％。结论：AOSD表现为高热、皮疹、关节痛、血白细胞和炎症指标升高，排除感染和肿瘤后应考虑AOSD，激素联合免疫抑制剂治疗有效；大多数患者能在4周内达到病情缓解，但维持阶段病情易复发。
目的：探討成人斯蒂爾病（ AOSD）的臨床特點、實驗室檢查結果、療效及轉歸。方法：迴顧性分析82例AOSD患者的臨床資料，總結臨床特徵、藥物治療方法、療效併進行隨訪。結果：臨床錶現為高熱98．78％，皮疹95．12％，關節痛和（或）關節炎82．93％，嚥痛78．05％，淋巴結腫大41．06％，脾髒腫大36．59％；實驗室檢查中白細胞增多78．05％，C 反應蛋白升高98．78％，紅細胞沉降率增快97．56％，血清鐵蛋白升高97．56％，乳痠脫氫酶升高86．21％，纖維蛋白原升高76．79％，D-二聚體升高80．36％，肝功能異常40．24％。98．78％應用糖皮質激素，89．02％患者聯閤應用瞭免疫抑製劑；血清鐵蛋白≥2000 ng／ml組複髮率高達71．43％。結論：AOSD錶現為高熱、皮疹、關節痛、血白細胞和炎癥指標升高，排除感染和腫瘤後應攷慮AOSD，激素聯閤免疫抑製劑治療有效；大多數患者能在4週內達到病情緩解，但維持階段病情易複髮。
목적：탐토성인사체이병（ AOSD）적림상특점、실험실검사결과、료효급전귀。방법：회고성분석82례AOSD환자적림상자료，총결림상특정、약물치료방법、료효병진행수방。결과：림상표현위고열98．78％，피진95．12％，관절통화（혹）관절염82．93％，인통78．05％，림파결종대41．06％，비장종대36．59％；실험실검사중백세포증다78．05％，C 반응단백승고98．78％，홍세포침강솔증쾌97．56％，혈청철단백승고97．56％，유산탈경매승고86．21％，섬유단백원승고76．79％，D-이취체승고80．36％，간공능이상40．24％。98．78％응용당피질격소，89．02％환자연합응용료면역억제제；혈청철단백≥2000 ng／ml조복발솔고체71．43％。결론：AOSD표현위고열、피진、관절통、혈백세포화염증지표승고，배제감염화종류후응고필AOSD，격소연합면역억제제치료유효；대다수환자능재4주내체도병정완해，단유지계단병정역복발。
Objective:To investigate the clinical features,laboratory findings,therapeutic response and prognosis of adult-onset Still′s disease(AOSD). Methods:The clinical data were retrospectively analyzed in 82 patients of AOSD regarding the clinical manifestations,medication options and therapeutic response through follow-up.Results:AOSD was primarily characterized by spiking fever(98.78%),skin rash(95.12%),polyarthralgia and/or arthritis (82.93% ),sore throat(78.05%),lymphadenectasis(41.06%),and hepatosplenomegaly(57%).The laboratory findings were associated with leukocy-tosis (78.05%),elevated C-reactive protein(98.78%),increased erythroeyte sedimentation rate (97.56%),elevated scrum ferritin (97.56%),elevat-ed lactate dehydrogenase(86.21%),increased fibrinogen(76.79%),D-dimmer increase(80.36%) and liver dysfunction(40.24%).98.78% patients were treated with glucocorticoids and 89.02%by additional use of immune suppressants.Patients with scrum ferritin(SF) level≥2000 ng/ml had a high-er relapse(71.43%).Conclusion:The major clinical features in AOSD are fever,skin rash,polyarthralgia,leukocytosis and high markers of inflammation. Patients with such clinical picture shall be considered the possibility of AOSD after tumor or infection is excluded .Most patients can be controlled by glu-cocorticoid and immune suppressive drugs within 4 weeks,yet relapse may be at the stage of maintenane therapy.
